Autism Services Navigator
On Oct. 1, 2021, TRICARE introduced the Autism Services Navigator (ASN) role to the Autism Care Demonstration (ACD). Contractors, such as Health Net Federal Services, LLC (HNFS), are responsible for assigning ASNs to beneficiaries.
Who is eligible for an ASN?
To be eligible for an ASN, you must be new to the ACD as of Oct. 1, 2021. You are considered 'new' to the program if you:
- Entered the ACD on or after Oct. 1, 2021.
- Paused or discontinued services for more than 365 days if in the ACD before Oct. 1, 2021.
HNFS assigns an ASN within three days after completing the ACD enrollment process.
What is an ASN?
ASNs are licensed professionals (registered nurses, clinical psychologists, licensed clinical social workers, or other mental health professionals) with clinical experience in pediatrics, behavioral health, mental health, and/or autism spectrum disorder.
How do ASNs support beneficiaries?
The ASN's role is to support the beneficiary and their family as a health care advocate, helping them navigate the ACD and maximize the services available. Responsibilities of an ASN include:
- Working with families to develop and maintain comprehensive care plans.
- Coordinating medical and mental health care services with the beneficiary’s providers.
- Coordinating and participate in medical team conference meetings.
- Helping beneficiaries new to the West Region with medical appointments and coordination for those moving from the East Region or within their existing region.
- Helping connect families with local resources and supports.
- Beneficiaries who are assigned an ASN and move remain eligible for an ASN as long as they continue to meet eligibility requirements.
- Eligible beneficiaries who decline the services of an ASN lose ACD program eligibility.
- ASNs role is as their assigned families’ heath care advocate; they do not perform clinical necessity reviews of ABA treatment plans or make TRICARE coverage determinations.
What if I'm not eligible for an ASN?
Beneficiaries who entered the ACD prior to Oct. 1, 2021 and are not eligible for an ASN have access to case management services, either directly through HNFS, their assigned military hospital or clinic (if available), or the Exceptional Family Member Program (EFMP).
To connect with HNFS’ case management team, visit the Care Management section of our website. Families can also connect with our case management team by calling our dedicated case/care management line at 1-844-524-3578.
Comprehensive Care Plans
Comprehensive care plans (CCPs) incorporate every aspect of a beneficiary’s care into one, comprehensive resource document.
The development and maintenance of CCPs help families:
- Track ACD and TRICARE Program requirements to ensure compliance.
- Set and track goals for the beneficiary’s short- and long-term care.
- Ensure outcome measure cycle dates are met.
- Monitor beneficiary’s progress and parent stress levels via outcome measure scores.
- Track respite care availability through ECHO & EFMP (when applicable).
- Document information related to transitioning care (such as PCS).
Note: CCPs do not replace treatment plans. The CCP and treatment plan work together to ensure the support and services provided are appropriately addressing the beneficiary’s needs.
Developing/Updating the CCP
After first meeting with the ASN, the ASN will develop the initial CCP. This happens within the first 90 days of entering into the ACD. After that, your ASN will update the CCP every six months.
CCPs are separate from and do not replace the treatment plans developed by ABA providers. However, the CCP and treatment plan work in tandem to ensure your child is receiving the appropriate services and support.
You play an important role! If the ASN is unable to complete the CCP within 90 days due to family/beneficiary delays in responding to the ASN, approved ABA services will be put on hold until the CCP is completed. If the CCP is not updated every six months, HNFS will be unable to continue to authorize care.